A. Field of Invention
This invention pertains to an apparatus for performing phacoemulsification and fluid infusion and maintenance within the eye. The apparatus includes a sleeve with lateral outlets or ports for ejecting fluid into the eye in a predetermined pattern selected to prevent detritus resulting from the phacoemulsification to migrate away from the site and, possibly into the eye. The apparatus may also include a needle having a tip with several prongs directing sonic waves at the site of interest. The apparatus includes stabilizers incorporated within a silicone (or other pliant material) sleeve surrounding and maintaining the phacoemulsification needle in a stable, relatively central position within the sleeve, (Alternatively the stabilizers may be attached to the outer wall of the needle.) The stabilization of the needle relative to the infusion ports associated with the distal portion of the sleeve is intended to “normalize” flow from the sleeve and into the eye, and thereby mitigating the impact of sudden and forceful infusion flow against various anatomical elements within the eye,
B. Description of the Prior Art
Phacoemulsification is a procedure used to break up and remove the natural lens from the capsular bag within the eye of a person. Most often the procedure is used as a means of treating a person having cataracts. The procedure involves making a small incision in the eye and introducing a thin needle formed on a horn through the incision. The horn is coupled to an ultrasonic generator that vibrates the needle in a predetermined ultrasonic frequency range causing the natural lens to fragment and become emulsate. The nuclear emulsate within capsular bag is aspirated during this process and simultaneously irrigation (infusion) produces a stabilizing effect in the anterior and posterior chambers, keeping the eye inflated.
To complete the operation an intraocular lens implant is then inserted into the capsular bag (usually through the same incision incorporating the ultrasonic handpiece).
While the technology has for the most part been broadly accepted as the community norm presently available equipment is noted to have several disadvantages. One these disadvantages is that in a typical equipment for performing phacoemulsification, the infusion (delivered by the surrounding sleeve) and aspiration functions (via the central bore of the phacoemulsification needle) are inherently in close proximity. Due to the unfettered ability for the phaco needle to make wide excursions within the surrounding infusion sleeve, under certain conditions the infusion fluid stream within the eye may interact in a deleterious manner tending to drive lens detritus away from the aspiration flow. Because of this phenomenon the phacoemulsification process is not only inherently less efficient but nuclear or other lens material may be driven far afield of the hand-piece, become lost to the surgical field, and at times remain in the eye in various hidden anatomical locations. Additionally fluid, forcefully entering the eye via the ports adjacent to the tip of the phaco needle tends impact on the iris under certain conditions as well as driving fluid into the back if the eye, inviting a form of intraocular glaucoma known as misdirected aqueous.
Another disadvantage of the existing apparatus is that the ultrasonic generator and the needle being vibrated has a tendency to generate excessive heat and must be cooled by infusion fluid to insure that the heat thus generated does not cause any internal injuries in the eye. A further disadvantage of existing phacoemulsification apparatus is that the needle ends in a ring-shaped end that is not a very effective emitter of ultrasonic sound waves and therefore the apparatus ultrasonic waves of relatively large amplitudes.